Winn v. Pioneer Medical Group (May 19, 2016, S211793) __ Cal.4th __
Defendant physicians provided outpatient medical care to plaintiffs’ mother, who suffered from vascular disease in her right leg. Though her condition worsened over a two-year period, the physicians never referred her to a vascular specialist. Ultimately, she developed gangrene, underwent amputations, and eventually died from complications. Plaintiffs then sued the decedent’s treating physicians for elder abuse.
The trial court sustained defendants’ demurrer, ruling that plaintiffs failed to adequately allege that the physicians denied their mother needed care in a reckless manner and that the professional negligence allegations cannot support an elder abuse action. The Court of Appeal reversed, holding that an elder abuse claim under Welfare & Institutions Code section 15657 does not require the defendant healthcare provider to have a custodial relationship with the patient, and that plaintiffs had sufficiently alleged reckless conduct such that the issue should be decided by a jury. The California Supreme Court granted review, and reversed the Court of Appeal’s decision in a unanimous decision authored by Justice Cuellar.
The Supreme Court held that the Elder Abuse Act required the existence of a custodial relationship to establish a cause of action for neglect, and no custodial relationship was established by the defendants providing patients with medical treatment at an outpatient facility. First, the Supreme Court held that “a claim of neglect under the Elder Abuse Act requires a caretaking or custodial relationship — where a person has assumed significant responsibility for attending to one or more of those basic needs of the elder or dependent adult that an able-bodied and fully competent adult would ordinarily be capable of managing without assistance.” The court explained that “it is the defendant’s relationship with an elder or a dependent adult –– not the defendant‘s professional standing or expertise [regarding whether a determination that medical care should be provided] –– that makes the defendant potentially liable for neglect.” Thus, “neglect requires a caretaking or custodial relationship that arises where an elder or dependent adult depends on another for the provision of some or all of his or her fundamental needs.”
The Supreme Court rejected the plaintiff’s argument that the Elder Abuse Act neglect standard applied whenever a physician provides medical treatment to an elderly patient at an outpatient facility—“[r]eading the act in such a manner would radically transform medical malpractice liability relative to the existing scheme.” Accordingly, because the plaintiffs’ complaint failed to include sufficient factual allegations showing that the decedent “relied on defendants in any way distinct from an able-bodied and fully competent adult’s reliance on the advice and care of his or her medical providers” the complaint was insufficient to support an Elder Abuse cause of action based on the requisite “caretaking or custodial relationship” between the defendants and the decedent.
Thomas Watson – Horvitz & Levy LLP
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